My Reading List (Are you sensing a theme?)

Here is an inventory of books I have read on my self-help journey.  

Stop Walking on Eggshells: Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder
  
The Sociopath Next Door

The Places that Scare You: A Guide to Fearlessness in Difficult Times

Mindset: The New Psychology of Success
  
Will I Ever Be Good Enough?: Healing the Daughters of Narcissistic Mothers

Reinventing Your Life: The Breakthrough Program to End Negative Behavior and Feel Great Again

Face Your Fear: Living with Courage in an Age of Caution ** 
Feeling Good: The New Mood Therapy **

Anyone who knows me, knows the theme to this particular reading list. I view each book suggested to me as a life-line friends have given me along my path. I have derived a lot of benefit out of all of these books--some books more so than others, but there's something useful to be found in all of these books.

Regarding the two books at the end of the list, and why do they have asterisks?

The book, Face Your Fear, has been on my bookshelf for years, and this weekend in the course of doing an annual culling, I have spared this book from this year's culling. I opened up the book to where my bookmark was where I left it, and I immediately was hooked (again). I think enough time has elapsed from when I last started reading it, and I think I am more receptive to actually facing my fears. Rabbi Boteach is a great writer, so it will no doubt be a wise investment of time.

The last book on the list--well, there's a bit of a back story regarding this book--and a TWIST, an interesting development.

About five years ago (+/-), I sought out a consultation with a psychiatrist to see if they could test my brain chemistry. I was hitting rock bottom again, and before I entertained going back on antidepressants** again, I wanted to find out which particular neuro-chemical was out of whack. My thinking was that I didn't want to waste more time on a seratonin reuptake inhibitor, if let's say, my dopamine was the real culprit.

I was up front when I made the appointment about the nature of my consultation. They wasted my time. I sat there and was assessed, and wasted an hour (or more, if you factor in the time to go into NYC and back home again), only to be informed "we don't do that." The doctor then handed off a free copy of the book Feeling Good, and I was on my way.

At the time, I thumbed through the book, and scoffed at the idea of THINKING my way out of depression. I'm a smart woman. Surely, if it were possible, I would have figured it out by now, so why am I still struggling? 

So, five years ago, in my annual culling, I got rid of Feeling Good. And in the course of a conversation recently (within the last 2-3 months) did I mention and suggest this book to a friend (a friend who had recommended at least two books on the above-mentioned reading list). So I re-read the editorial reviews and the customer reviews on Amazon, and decided I was too hasty in culling the book, and I ended up buying another copy. 

Right around the same time frame when I was suggesting the book to my friend**, I had a pretty horrible thing happen to me professionally and personally, and I realized I needed to dump my therapist of nine years, of which, I've posted about and alluded to within this blog as well as the blog devoted to my mom and other dysfunctional relatives.

January 3rd I did the deed, and dumped FIRED my therapist, and started a quest to find a new one. It took me two straight weeks of making calls and refining my search several times until I found the person who I hope will decide to continue on as my therapist.

Now for the twist: The type of CBT she utilizes is the one the book Feeling Good is based upon. 

So, while I am frustrated at the idea of my previous therapist holding me back for nine years, and I have nothing to show for all that time, no progress, no new job or an improved emotional or physical state; I *DID* have the POTENTIAL solution in my hot little hands FIVE YEARS AGO.

Confession: One of the many problems I have is my inability to finish things I start. Several of the books listed above I started and read 75-90% of the way through and got distracted or lost interest or or or... well, I am the queen of excuses. I think ultimately, my problem is that I have not made myself a big enough priority.

**It bears sharing, that I have gotten more therapeutic benefit out of my friendship with "S" than I got out of nine years with a professional therapist & social worker. I only hope that I have been as big of a support to him as he's been to me. Between his support, and the Maharajah--I honestly don't know where I'd be, and for whatever amount of wallowing I allow myself to do, it's a splinter's worth of what it'd be without these two valuable supports in my life. 

Kaizen 2019: Day One

I had hopes on January 1, to get back into the swing of things THEN; however, it's taken me 27 additional days before I got back on my bike.

I knocked out 30 minutes this morning.

Tomorrow is my 2nd (of 2) assessments regarding CBT in the morning, so no bike until Wednesday.

Stay tuned to see if I get back on it on Weds--if that happens, hopefully, I'll be able to kickstart my habit again, but all I know is TODAY I managed to make myself a priority first thing in the morning.

Perhaps I'll start drinking more water, too. 

PERHAPS.

This Year's Project: CBT

Today was the first of two appointments, which are assessments for CBT, which I hope will help me move forward.

Just Burn It All To The Ground

Just divorce me.
Just fire me.
Just put a bullet in the base of my skull directly into my brain stem to shut everything down ASAP.

I am in the abyss and I cannot extricate myself.

Fuck you for your silence.

Intermittent Wallowing

Still wallowing and feeling sorry for myself and HOLY SHIT AM I DEPRESSED! 

Yet, I still managed to continue my search for my next therapist. I called a psychology group where two therapists on my list are located. So now I hurry up and wait for them to give a call back. If I get no traction with either candidate, next week I will reorganize my efforts and contact the insurance company and see about preferred and participating practitioners nearby.

Eleven days into the new year (eight of which have been since I fired my previous therapist), and I feel like I am stuck at square one.

In addition to contacting today's candidates, I also managed to schedule an appointment with a neurologist for a consultation in my on-going quest to find out what is at the root of all the pain.

Living in pain, anxiety, depression is no way to live. The more pain I have, the more depressed I am, and the more depressed and anxious I am, the more I am stuck in my cycle of pain.

Also worthwhile mentioning, the Maharajah got a bottle of CBD oil, and I used some on my knee, elbow and low back, and I don't know how long I should use it before I start to notice any results. But at least it's one more thing to tick off my list of things that we tried.

I guess.

Now if you'll excuse me, I need to go to lunch and self-medicate with some fried chicken.

New Year--Same Old Me

To say I am struggling is an understatement. 

I have backslid on my bike routine to zero. I made an attempt on New Year's Day to reinvigorate my bike habit and managed to get in the saddle precisely once in the new year.

My trip to India decimated me physically. The trip was arduous, though surrounded by loving people. And then there was the lingering question of whether I was infected with Swine Flu or not, and here I am. Wallowing, and depressed, and (SURPRISE SURPRISE) still in pain.

My mom is still up to her usual routine, so I've tucked her away in the box in my mind, and I'm choosing not to deal with her unless absolutely necessary as there is zero return on that investment--and I have not allocated even one solitary SPARE fuck with which to dispense on that charity case.

Additionally, I did the deed on 1/3, and my first official act of 2019 was dismissing the therapist with whom I have had sessions since 2009. Periodically throughout the 9 years, I'd reassess about every 18-24 months (so roughly five times) whether I have gone as far as I can with our therapy sessions, was I meeting my goals? 

To be honest, I've gotten far more tangible benefit out of my interactions with a friend of mine in Northern Ireland, who is on a similar journey. He and I check in periodically (sometimes multiple times daily, to sometimes less often) and he's been a great sounding board and a wonderful support for me. Additionally, he's recommended several books to me, and I've bought several and derived a lot of benefit out of them--so much benefit, I've decided to try to find a new therapist, one who specializes in schema or EMDR (or both) therapy. Sad to say, but I feel my prior therapist was keeping me stuck. 

By the time of our last session (December 26th), my mind was made up that I needed to make a change. It was time for him to "cut bait," and I'm ready to go fish. I've wanted and needed far more structure in our sessions. Instead, for nine years it was pretty much me doing word vomit until we find something interesting, and we chew on it a little bit and before I knew it, our time was up. I was always the one to remind him, or circle back to what we talked about in our previous session. I always used our sessions as a way of organizing thoughts and I'd always come away from our sessions with a "to do list" which I created myself. The next session would involve me ticking off which items were done.

The "October Discussion" at work was enough for me to realize my coping mechanisms are failing me. I need more substantive coping mechanisms and conflict resolution skills. I need to address the underlying issues and schemas which shape me, and my actions/reactions in the world. I am tired of ME holding ME back. But really it's not ME, it's the garbage and abuse I suffered, but it's really MY RESPONSE to all those past experiences which is holding me back today.

The short list of things I want to accomplish with my new therapist, in no particular order:
1. Somehow heal from the stuff done to me (or at least the stuff I am AWARE that was done to me);
2. Stop negative self-talk;
3. Stop being risk-averse;
4. Change my fixed mindset to a growth-oriented mindset;
5. Establish and maintain healthier habits regarding sleep & exercise.

One thing I have become super aware of as of late is how all my life I had been given "crumbs" in life, people closest to me giving me scant attention or love or support (or or or...fill in the blank), and with the abandonment schema being a big thing for me--I have been cultivated to have a disproportionate amount of appreciation for those crumbs--the tiniest of gestures get over-inflated in my mind, and interpreted far more intensely and with more importance than I should. 

All my life, I've been fed crumbs, and have been led to act as if it were a fucking feast served to me. I am officially tired of being Oliver Twist--and I won't be imploring, "Please---I want some more" from anyone anymore.

My work-life and interior life are out of harmony. My depression and anxiety and pain are the ones in control now. I am on cruise-control and not sure how or when this will change. If there were a way for me to will myself to cease existing, it would have happened by now.

I have long held the opinion that some friendships are like Twinkies, and others are like dairy products. 

Surely, a glass of cold milk and a Twinkie make a pleasant snack, and we need a mix of these friendship types in our tribes/herds/circles of friends. 

Twinkies are durable, reliable, and long-standing. They will be ready for you when you want or need them. They literally stand the test of time.

Dairy products, on the other hand, have a much shorter shelf life--you're lucky if a gallon of milk lasts a week after opening it.

So before you reply--if you reply--ask yourself on question: Are YOU a Twinkie? 

Seems like a supercilious question; however, let's just say, I've built up a "lactose intolerance" of sorts.

I'm done "paying it forward." I'm done making deposits into the bank account of good will. I'm tired of takers taking without reciprocating.

And if any of this angers you--I'll revert back to one of my dad's sayings, "Don't go away mad, just go away."   

If you're not actively helping or playing a supporting role in things, you are part of my collection of problems. So, in short, I won't be chasing after anyone anymore. I will be in what I call "the power position." I'm going to work pretty hard at being able to identify and NOT insert myself in situations, unnecessarily.

Kaizen: Day 272

Thanks to my travels last month, I have backslid ENTIRELY. I have not been on my bike in about 34 days.

I thought while I was in India, I'd use the exercise room at my in-laws' apartment complex, but that would've involved an escort, and it was too damned hot and humid for me to consider expending any additional energy. 

While In India, I did manage to get an aryuvedic massage at the ashram I was staying at in Kumbakonam; and I later went to an aryuvedic doctor in Madras to hopefully get some solution/s to my chronic pains. So there's that--I managed to do SOMETHING towards my goals, but in the meantime I backslid entirely. 

Then there was Thanksgiving, and work, and no real amount of downtime for me to recover from everything, and here I am 34 days and no bike.

I've set two alarms: one in the evening with a reminder SLEEP HYGIENE! to hopefully motivate me to get out of my heated zero gravity chair and brush my teeth and take my meds and set up some things for the following day, and hopefully get into bed by a decent time (no such luck--I ignore this alarm every damned night); and one in the morning at 6 a.m., hoping one day I'll just "Five Second Rule" myself out of bed and onto my bike.

Couple all this up with the fact I haven't talked to my therapist since the third week of October, and since he's going through chemo it is doubtful/unlikely/uncertain when (if at all) I will speak with him again before the year is out.

But come January, I will be seeking out a new therapist to hopefully help me work through and manage my schemas, and hopefully help me with my mindset.

That all said, despite not getting out of bed this morning, I did manage to hit the snooze alarm--and I used my resistance bands and started back into THAT routine. Hopefully I'll be motivated tomorrow to do it too. And with any luck, maybe Saturday I'll get back on the bike. Maybe.

Kaizen: Day 258

I have backslid 100%.

Prior to our recent trip abroad, I had something horrible/challenging happen to me at work, which ended up depressing me. However, something useful did come of it all, and I've decided to find a person who specializes in schema therapy.

Then our trip abroad effectively gummed up the works and got me 100% off my schedule regarding my bike.

Despite that, while we were away, I did manage to go to both, an aryurvedic ashram, and another aryurvedic clinic while we were away, where I received aryuvedic massages, and at the second place, supplements and exercises to help facilitate some change in my collection of pain issues.

Only time will tell if it will ultimately help.

And Thanksgiving will be here in "one day and a wake up," so there's no chance of getting back in any kind of routine until AFTER the holiday. 

Next month, I have three appointments set, and hope to get some good news from my kidney guy--good news in the form of a discussion that goes thusly, "Okay, tell me what you're doing differently." I feel like I'm battling an invisible dragon in regards to my protein levels in my urine.

Anyway, more to report in a couple weeks or so (I hope).

Not That It Matters

And I doubt it heavily, whether anyone reads this blog, though I DO blog for my own self, purposes and record keeping...

I am becoming increasingly more depressed.

Between the ongoing pain issues that won't resolve themselves fully, and dealing with some family bullshit head on, and everything else I listed in my litany yesterday about how my August has been off-kilter, I'm depressed.

I ditched Facebook finally last month, and that has cut down/damn near eliminated my online socializing completely. So rather than feeling shitty about seeing friends interacting with other people and not responding to message I've sent them, I now am feeling shitty about the void, the abyss, the abject lack of give a fuck by people I considered friends.

I updated my contact list before ditching FB, and I am actually going to identify which people I remain in contact with, and adjust myself and my expectations accordingly.

Surely, I expect too much from people. This is the far better thing to think rather than to think that so many people were just superficial/casual acquaintances (with 1-2 shared common interests) rather than actual friends. 

This isn't a boo hoo attempt at attention whoring. I am physically and emotionally drained, so everything else gets analyzed and perhaps exaggerated a bit as a result. 

Kaizen: Day 173

Maintaining 30 minutes on the bike daily. Though for a while there, I was setting an alarm to get up by 5:55 every day, and was knocking out an hour a day, Monday-Friday. Then I dropped down to Monday, Wednesday, Friday. 

For the last few weeks I've been very flat, perhaps even depressed. Of the litany of reasons why my mood is bottoming out might be:

1. August's heat and humidity.
2. Spending the majority of the month without my co-worker who sits closest to me (who is the first person I see daily and is a very positive person). 
3. I have been on Jury duty for the last few weeks. 
4. I told off a petty, trouble-making relative.
5. I turned 50 this month.
6. Or it might be a combination of these things. 

Also worth mentioning, that for the entire month of August, my physical therapy appointments which normally are on Saturday mornings, had to be moved to Tuesday nights this month, because my physical therapist isn't available--and this really threw a monkey wrench into the structure of my Saturdays, as my physical therapy appointments were the catalyst to get me out of the house, and into motion do do doing things. So my whole routine has been off, and I just feel wiped out. 

I haven't done anything towards improving my sleep hygiene, and I'm still struggling to get out of bed in the morning, and by extension, this is impacting how much time I get on the bike. Plus, we've had a few cool evenings, which makes it great sleeping weather, so once I finally DO drop off, the last thing I want to do is get out of bed.

This weekend, I didn't bother getting on the bike at all, so I absolutely had to make an attempt today, otherwise, I was fearful of backsliding completely. 

I'm keeping up with all my supplementation and self-care.  

Physical therapy tomorrow, and chiropractic on Thursday. Beyond this, nothing new to report.

*Note: Physical therapy never happened. This therapist became increasingly more difficult to schedule appointments with. His unavailability was part of a greater cascade of events which have actually added to my pain, anxiety, and depression issues.

Kaizen: Day 111

Got up at 6 a.m. 

I knocked out 30 minutes on the bike, packed my lunch, and managed to make a batch of Beef Burgundy in my pressure cooker, before showering up and heading out for an 8 a.m. orthopedic appointment which was booked spontaneously yesterday.

Not to belabor the point, but I'm in a LOT of pain. The NP has been going through the motions to file an appeal with the insurance company to approve the hyaluronic gel injections for my knee. This has been going on since May, as I was hoping to get the shots on schedule in June. And here it is, June is almost over and no shots. 

I called the NP to follow up on a voicemail she left me, and mentioned how much pain I am in, and can I get a cortisone shot in the interim while we wait for the insurance appeal process to conclude.

I got the shot in the knee, plus an Rx for more PT, plus an Rx for meloxicam. 

On my to do list today, I need to update my supplement list, and email that PLUS my full radiology packet to the NP.

Perhaps some TEMPORARY relief is in sight.

PERHAPS.

While I am philosophically opposed to cortisone, for what I feel are justifiable reasons, at this point, I'd snort Draino if someone said it would help. I view the cortisone as = to Draino at this point. 

Doing nothing, as always, is not an option for me. Even sitting still, appearing inert, I am always thinking.

The only card I can play right now is to do whatever is necessary to keep walking, and at the moment, the cortisone + meloxicam is the only option for me (well, the only option, in addition to my regimen of chiropractic adjustments, acupuncture, and physical therapy). 

Look how dismissive I am about "the only card."  On the surface, I'm so dismissive as if I only had one of a kind; but the reality is, I have either four of a kind, or possibly 1 card shy of a full house. (I need to get better about my playing card analogies.)

All The News That's Fit To Blog

Oh crap. I thought I had enough stamina and give a fuck to sit here and peck out an update regarding Monday's trinity of appointments. I guess I'll have to do a quick and dirty.

Appt #1: Rheumatologist. Clear bill of health. No auto-immune inflammatory diseases causing my pain. NEWEST DIAGNOSIS: enthesitis. On an upnote, my blood pressure was 110/64, so apparently, the combination of riding my bike 30 minutes each day, PLUS tinkering with my magnesium formulation (I transitioned from magnesium oxide which I was on for years, to magnesium glycinate, and in the last 3 weeks I transitioned to magnesium taurate). My bp was trending lower when I got my bp checked before acupuncture appointments, but this was my lowest reading yet.

Appt #2: Orthopedic surgeon. I went for a consult to see if I could get surgery on my knee. Turns out, despite the degeneration and oseophytes in the knee, I'm not "there yet," and the result of the physical exam was that the bulk of my pain isn't from the degeneration in the knee, but is soft tissue realted. Second diagnosis of the day: enthesitis.

Appt #3: Endocrinologist. I decided to err on the side of being conservative and seek out an endocrinologist. It was 14 long years of going 3-4 times a year to my former endo, and I was hoping I could get away without an endo. Initially I thought my GP could handle things, and then I got it in my head that a possible mover-and-shaker for the pain might be hypothyroid. The appointment was informative and uplifting, and I don't have to go back for another year.

So while yes, the results were good and positive: Yes, my blood pressure is the lowest it's been since I was in my early 20s; and NO, I don't have RA, Psoriatic Arthritis, Fibro, etc; and NO I don't need surgery yet--getting a diagnosis of enthesitis doesn't really help me. I already knew or sensed what this IS (pretty much it's a systemic tendonitis and inflammation of the enthesis, the point where tendons attach to the bone--and possible arthritis related to this too), it doesn't help me eliminate or even minimize my pain.

Hell, even my theory of it being pseudogout was a nonstarter--as my TSH report from the endocrinologist came back well within normal parameters. 

The day was beautiful, and appt 1 and appt 3 were both at the same location, with the ortho blowing a hole through my day by not being able to move that appointment later in the afternoon. 

Appt #1 and Appt #3 were at E85th, and Appt #2 was at E38th. And well, once Appt #2 was over, I convinced myself to WALK back to E85th. And I did more walking afterwards, and before I knew it, by the time I got home, I realized I overdid things. Here it is, four days later, and I am now walking with my cane. If I have a good day, a good day is as bad as a bad day (or perhaps even WORSE than a bad day), because I end up overdoing things and paying a hefty price for days or weeks after.

Imagine it. Me. In pain. Back, hip, knee, groin, you name it, and I managed to walk this far.

I have no recourse for treatment other than to find YET ANOTHER physiatrist*, start from scratch with them, get more Rx for PT, perhaps get some cortisone shots (yes, plural) and hope that helps get me through the hump. And I've been doing a bit of research regarding buying a cool laser so I can treat myself at home. Pricey! But I am sure it will all even out, if I were to factor in how many appointments I'd need with my chiropractor before I start feeling any relief. 

So, I am now bottoming out, mood-wise, I feel like shit, and I'm walking with my cane, and I'm wondering why it's an ALL OR NOTHING thing with me. Why couldn't I just have stopped walking?

*Note: It took me eight more months until I located my fourth physiatrist, aka P4.0. 

THEN AND NOW

Medications that I used to be on before my gastric bypass:

Riomet/metformin
Actos
Tricor
Effexor
Quinipril
Aldactazide 

Additionally: I was on Xenical and later Topamax, both with the promise of helping me lose weight (and the Topamax was promised to help my migraines), and both medications did NOTHING except make me miserable. I was also promised the metformin would help me lose weight and what a load of horse-shit THAT promise was. I had over 10 years of gastric distress.

After my bypass, how many of those medications am I still on?  TWO: quinipril and aldactazide.

Medications & injections I have tried in the past to help my assortment of pain:

Cymbalta: The promise was it would help w/depression and low back pain; it did nothing except make me gain 10 lbs I have YET to dump off;
Frova: This helped me a lot; and about 3-4 years ago, a neuro-ophthalmologist I was seeing suggested I start taking Vitamin B2 every day, and I stopped taking the Frova entirely; 
Kenalog: I had precisely 1 kenalog injection into a facet joint in my spine and it did nothing;
Cortisone: I had precisely 1 cortisone shot in my elbow and it did nothing;
Synvisc/Euffexa: I went through a year of shots 3 in each knee, 2x last year, and it helped, minimally. 
Topamax: I went on this one more time, this time at the suggestion of my neurologist, who promised me it would help with my chronic pain in my low back--it did nothing for the pain.
Tramadol: I had an Rx for this for the longest time, and to be honest, it didn't do all that much except make my head fuzzy.
Flexeril: It worked in so far as it helped me relax enough to go to sleep. 

Pain medications I am on to this day: ZERO.

Treatments I have had in the past for my pain:

Physical therapy--though it was all exercise, no hands-on fascia work
Kenalog injection
Diflucan patch
Diflucan gel
More physical therapy
Occupational therapy with a hand specialist for my unrelenting elbow pain
Chiropractic
Deep tissue massages
Trigger point injections with massages after
Synvisc/Euffexa injections
High volume saline injection under IT band
Cortisone injections in bursa in elbow and hip
Ultrasound
Cool Laser
TENS/EMS

Of those treatments, which ones do I continue to this day: ZERO.

Current pain management plan:

Chiropractic
Physical therapy w/myofascial work & traction
Acupuncture
Deep tissue massages 

I would like to buy a professional grade cool laser for home use. And I am actively looking into getting my right knee replaced.

Speculating on Cascade Effect

I cannot help but wonder if my gastric bypass which I had in 2011 is to blame for so many of the problems I am having:

• Thyroid nodules (Possible new diagnosis I anticipate coming: Hypothyroidism)*--I don't recall having them (or as many of them) prior to the bypass. Surely, losing weight made detecting the nodules more obvious; however, I wonder if this is the result of the excessive amounts of calcium citrate my bariatric surgeon insisted I take daily (2000 mg). I only cut it down to about 800 mg about 3 years ago, so I cannot help but wonder.
• Proteinuria--I don't recall having this big of an issue with protein in my urine like I do now. I vaguely recall "microalbumin" but it wasn't anything my endocrinologist would remark upon. I cannot help but wonder if this is the result of my diet being protein-focused, and I'm considering dropping my daily protein shake (23 gm).
• Hyperuricemia--I don't recall being diagnosed with gout or borderline for gout, prior to my bypass. I know I was being monitored for it, but I don't recall all too many months where my lab reports documented levels in the 6-7 range. Again, too much protein? Or some other root cause? Between the proteinuria and the hyperuricemia, I am TERRIFIED of kidney failure.
• Chondrocalcinosis (Possible new diagnosis I anticipate coming: Pseudogout)*--Last year I had an MRI of my knee and the notes had a remark about chondocalcinosis present. This is above-and-beyond osteoarthritis, and from what I can determine from just a preliminary skim, the chondrocalcinosis is calcium crystals, whereas “gout” is urate crystals.  I have sought out a rheumatologist for a consult, and found a new endocrinologist and hope to get this mystery figured out.
• Post-Prandial (aka "Reactive") Hypoglycemia--It seems in my zeal (and terror) to reverse my risk factors for Type II Diabetes, I have traded it off for post-prandial hypoglycemia. I am not on medication for this, and manage it by eating multiple smaller meals throughout the day, and avoiding excessive consumption of refined carbohydrates. Even things like fried chicken could be enough to make my glucose dip a bit. I do love crunchy pretzel thin crackers (not more than 1-2 oz), but you gotta live a little--right? Mama needs flavor and texture.
• Enthesitis*

*I have noted these three with an asterisk as they could very well be linked or otherwise inter-related. I have my suspicions of the hypothyroid, as I've got a lot of symptoms that could be related to hypothyroid (which could have been dismissed as symptoms of my PCOS). 

Also, it'd be nice *IF* hypothyroid *IS* the culprit rather than pseudogout or RA, or Psoriatic Arthritis. Given the choices of medications, I'd say Synthroid is the lesser of the evils (evils being things like methotrexate, Colchicine/Allpurinol, and other medications that carry with it more unpleasant side effects).

I have highlighted in red the hypothyroid symptoms which I currently am experiencing:

• Fatigue
• Increased sensitivity to cold (more pronounced after my gastric bypass)
• Constipation (more pronounced after my gastric bypass)
• Dry skin
• Weight gain & inability to lose weight (See also: PCOS symptom)
• Puffy face
• Hoarseness
• Muscle weakness
• Elevated blood cholesterol level
• Muscle aches, tenderness and stiffness
• Pain, stiffness or swelling in your joints
• Heavier than normal or irregular menstrual periods (See also: PCOS symptom)
• Thinning hair (See also: PCOS symptom)
• Slowed heart rate
• Depression
• Impaired memory

In the interim, between seeing my rheumatologist on 5/23/18 and when I see him again for a follow up on 6/18/18, I have held off on taking my resveratrol and cherry extract, and I have cut my alpha lipoic acid in half. 

The alpha lipoic acid and the resveratrol might be impacting the conversion of T3 to T4 (and I don't know enough about what testing that was done in the past to know to what level or generation my thyroid function was being tested). But I figure it was worthwhile holding off on these particular supplements until I see the rheumatologist and the endocrinologist on 6/18/18.

Additionally, I am holding off on taking my cherry extract, as I am suspecting that there could be a possibility I was over-doing my anti-oxidants and perhaps my constant pain/discomfort might be the result of a pro-inflammatory effect. I figure a month without these supplements might be enough to see if my theory proves true. I just worry about the impact of going without will have on both, my cholesterol levels and my uric acid levels.

Kaizen Day 83 & An Update

Still at it with the bike, though I had physical therapy on Saturday and gave myself Sunday to rest, and back at it yesterday. Today I had to go to the dentist first thing in the a.m., so I had to blow it off--and I might try to get on the bike tonight--but I have a chiro appointment. 

Other developments:

5/23 I had a consultation with a rhematologist to get screened for things like RA or Psoriatic Arthritis, etc. I gave him enough information to support CPDD/CPPD (aka pseudogout), too. And given I am convinced I might be sub-clinical for hypothyroid--the pseudogout dovetails nicely with that. I also saw my kidney doc for my usual six month follow up visit. 

Bad news: I am up 5lbs (and I don't mean the 5-7 lb "vacillation" I have been struggling with, but 5 MORE pounds on top of that), so I'm up 10-12 lbs over where I want to be.

Good news: I think I may have tinkered my supplements enough where my diastolic bp has been trending towards a consistent /70 for the last 2 months. 

I also suspect the combination of anti-oxidants I have been on is too much, and maybe SOME of the pain I am experiencing might be a pro-inflammatory response, so I'm dialing things back a bit and waiting and seeing if it has an impact.

6/18 I have three appointments scheduled. First up will be the follow-up visit with the rheumatologist. 2nd appt of the day will be a consultation with the ortho who replaced my kidney doc's knee. 3rd appt will be my first appt with who I hope to be my new endocrinologist. Lots going on that day. 

Struggling to move, stay motivated, and trying not to let my anxiety and depression get the better of me. I don't have time to hold anyone else's hand/s these days, and even less patience to put up with some folks who are so self-unaware to realize they've been shitty disappointing friends. I get it, I've got a lot of issues, and I'm working towards changing that, but if I've said "I'm so depressed at the idea of a possible fibromyalgia diagnosis" and you, yourself have fibro, and you do not reply to that text on your phone (yet the day before, your text to me would rival War and Peace in length--and yet you claim you did respond--yet none was received on my end), I have nothing more to give. And this is the nicest way I could put this. I'm not going to get into it further. 

Kaizen: Day 50 (PS)

As I mentioned in my previous post, my biking has improved my stamina, but not much else that I can see on the surface. I had high hopes it would help my daily pain issues. But progress is taking different forms in revealing itself. First, improved stamina. And second, apparently, it's shaved about 18 points off my systolic blood pressure. My norm hovers around 138/80 or 140/90, and my bp for the last two readings at the doctor have been 120/80. Now IF ONLY I can get that pesky 80 down to a 70, I'd be satisfied.

Kaizen: Day 50

Struggling with depression and pain (STILL, I know), and thought I'd give myself today to sleep in a bit (45 extra minutes) and blow off the bike.

I got up at 7:30, and when I realized Maharajah was working from home today, I realized that I could manage my 30 minutes on the bike before getting myself ready for work. 

I cannot tell, does this mean it is now an ingrained behavior and habit?

I convinced myself I need it at least for helping with my circulation. And I knocked it out, no problem. 

But I'm still fucking depressed and despairing, and an upcoming vacation isn't enough to turn that around (newsflash: it NEVER is enough to turn things around). The sun and change of scenery will be nice, but right now it's too abstract for me to process or even anticipate.

No call or email from surgeon at NYU Langone yet. And I checked my email (the one I use for such purposes), and it's devoid of any replies regarding the resumes I sent out earlier this week.

During my session with my therapist yesterday, he and I both agreed that all things considered, I am "managing well" in spite of the setback of not getting the job, and no real resolution to the pain issues.

27 More days until I have the day of EPIC APPOINTMENTS (rheumatology consult, my nephrology check up, and the endocrinology consult). Was hoping to round things out with a consult with the surgeon.

Hurry up and wait.

Kaizen: Day 48

I have been maintaining 30 minutes on the bike every morning for several weeks (almost a full month now), and I am contemplating concluding each work day with another 30 minutes. Maybe that will happen at some point this week, I don't know. 

I'm more than a bit ambivalent with a lot of things right about now, primarily due to me daring to HOPE that the job interview would have led to a job. They let me sit and stew for four weeks and let me know this past Friday that I didn't get the job. Yesterday was yet another indication of how shitty this place is, and how I desperately need to get the fuck out of here, and yet, me and my shitty knees and pain problems intimidates me into thinking I cannot manage the subway stairs every day.

I was in Manhattan on Saturday, escorting the daughter and son-in-law of a dear friend around town. We went from Times Square where their hotel is, took the shuttle to Grand Central, then the 6 down to Little India, where we had lunch and did a bit of shopping, then Uber'd it down to China town and Little Italy for another knosh and coffee and pastries and Malaysian beef jerky shopping, and before I knew it, I had amassed 11,210 foot steps. I was going to share the screen cap of the fitness thingy from my phone, but I can't upload images to the blog ATM.

So while I have felt all along that the biking was not helping me in my day to day pains, apparently it has helped me in other ways, namely my ability to walk A LOT, and the next day was just like any other day for me. This is not to say I was pain free; however, I wasn't crippled up with ADDITIONAL pain, meaning MORE pain on top of my status quo baseline of pain.

I called NYU Langone this week to find out about scheduling a consultation with the surgeon who performed the knee surgery on my nephrologist. I sent them my imaging bundle of my lower extremities, and I should know, hopefully, by tomorrow if I can have a consult with that surgeon or if he will refer me to an associate. And while on the surface it might not seem like my knee problems are extreme enough to warrant a knee replacement RIGHT NOW, I am having horrible difficulties climbing the scant 15 stairs to get into my house, and couple that up with the IT band syndrome and the trochanteric bursitis in my hip (all on the right side), I am finding I am able to do less and less, and I fear that it will continue to self-perpetuate. 

Additionally, I am convinced the collection of pain issues is limiting my mobility and the things I choose to do, and is most likely the reason why I am unable to lose more weight, as well as having difficulties maintaining whatever I've lost as well.

Kaizen: Day 30

I think I am close to convincing myself that I have actually managed to establish riding my bike as a HABIT. Perhaps a bit more into this, and maybe I'll be confident of it. Leopards can't change their spots, and I am depressed and lazy and would rather do NOTHING, but that's not a choice I want to make.

That all being said, after roughly about a week of sustaining the 30 minute mark, and perhaps it's premature to expect greater things, but whomever said that exercising helps with pain management etc, is full of horse shit. My knees continue to hurt as much as they always ever have, and the tightness with the IT band syndrome, and my low back pain has not changed even in the slightest.

That all said, I'll stay the course, and try to get more consistent with giving myself an additional five minutes after biking for me to elevate my legs to help with blood flow, oxygenation, etc. Also, I am now hoping the biking regularly will help me get in front of the borderline left ventricular hypertrophy, which has me bugging out right about now.

I started the P5P supplement a few days ago, and I will have about a month of use before I see the nephrologist next month. Perhaps it will help? Who knows. I'll formulate some questions for that session, too. 

I got my report back from the thyroid ultrasound and my Pink Unicorn isn't going to send me in for a FNA; however, I think maybe I might end up needing a endocrinologist--but perhaps will set that up next year. Perhaps. I'm done obsessing, and yet at the same time, I want to be proactive. 

Kaizen: Day 28

I'm still chipping away at it. Have consistently done 30 minutes on the bike every day this past week, and a few days therein, I made attempts at incorporating an additional 5 minutes where I am elevating my legs after riding my bike, to help with blood flow etc.

This morning, I got absorbed in replying to a lengthy email, and rather than do 30 minutes, I ended up doing 53 minutes. I don't know if this will be a daily thing, or if I'll eventually work up to 45 minutes consistently, but 53 minutes happened today. Plus, I elevated my legs (and didn't have my timer on hand, so I counted to 100 as I elevated my legs).

Now, regarding doing Kaizen for my sleep hygiene--I haven't gotten control of that yet. I've been sleeping in my spare room, so as to have uninterrupted sleep, whenever I finally do manage to drag myself to bed. And at least once this week, I sprayed some "magnesium oil" on my knees and elbows and rubbed it in before bed, as it helps to relax me. 

Still chipping away. And I'm even doing Kaizen progress on other things: My annual organizing/purging of household stuff, as well as refurbishing a pair of sandals to possibly get one more spring/summer's use out of them.

KAIZEN ALL THE THINGS!